Best Mastopexy Technique for Tubular Breasts?

Thank you for the question.  
 
Some of the characteristics seen with tuberous breasts include a very narrow base, short distance from areola to inframammary fold, tight (constricted) lower pole of the breasts, relatively wide space between the breasts, "puffy" and areola and some degree of ptosis (drooping).  

Generally,  correction of tuberous breast anomalies involves breast augmentation with areola reduction / mastopexy procedure. The distance from the inframammary fold is increased (to create a more rounded out appearance). Proper implant positioning improves the distance (cleavage) between the breasts. The areola reduction helps to treat the pointed and "puffy" appearance of the areola.

In the most severe cases of tuberous breast, a more complete breast lift may also be necessary.  In many cases however, a lift is not necessary. The patient should be aware that the final result will take months to see and that they will need to be patient and that revisionary surgery is more likely than in patients who do not present with tuberous (constricted) breasts.
 
When you are ready, please make sure you consult with well experienced board-certified plastic surgeons who have significant experience with this type of surgery.

I hope this helps.
 

In general, I have found that the circumareolar technique with dual plane approach, radial relaxing incisions and submuscular placement of a high profile silicone gel filled implant to provide the best option for a tubular breast in my experience,

Without a formal exam it owuld be hard to tsay for sure, but in general a few things usually are required.1) to open the lower pole, 2)to reduce the areola and 3)sometimes to implode the breast tissue that herniates through the areola.  Sometimes a donut mastopexy with an implant can help.  If there is enough volume of tissue than several different techniques are available.